MHSafeEval: Role-Aware Interaction-Level Evaluation of Mental Health Safety in Large Language Models

Suhyun Lee, Palakorn Achananuparp, Neemesh Yadav, Ee-Peng Lim, Yang Deng


Abstract
Large language models (LLMs) are increasingly explored as scalable tools for mental health counseling, yet evaluating their safety remains challenging due to the interactional and context-dependent nature of clinical harm. Existing evaluation frameworks predominantly assess isolated responses using coarse-grained taxonomies or static datasets, limiting their ability to diagnose how harms emerge and accumulate over multi-turn counseling interactions. In this work, we introduce R-MHSafe, a role-aware mental health safety taxonomy that characterizes clinically significant harm in terms of the interactional roles an AI counselor adopts, including perpetrator, instigator, facilitator, or enabler, combined with clinically grounded harm categories. Then, we propose MHSafeEval, a closed-loop, agent-based evaluation framework that formulates safety assessment as trajectory-level discovery of harm through adversarial multi-turn interactions, guided by role-aware modeling. Using R-MHSafe and MHSafeEval, we conduct a large-scale evaluation across state-of-the-art LLMs. Our results reveal substantial role-dependent and cumulative safety failures that are systematically missed by existing static benchmarks, and show that our framework significantly improves failure-mode coverage and diagnostic granularity.
Anthology ID:
2026.findings-acl.1382
Volume:
Findings of the Association for Computational Linguistics: ACL 2026
Month:
July
Year:
2026
Address:
San Diego, California, United States
Editors:
Maria Liakata, Viviane P. Moreira, Jiajun Zhang, David Jurgens
Venue:
Findings
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Publisher:
Association for Computational Linguistics
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Pages:
27760–27793
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URL:
https://preview.aclanthology.org/ingest-acl/2026.findings-acl.1382/
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Cite (ACL):
Suhyun Lee, Palakorn Achananuparp, Neemesh Yadav, Ee-Peng Lim, and Yang Deng. 2026. MHSafeEval: Role-Aware Interaction-Level Evaluation of Mental Health Safety in Large Language Models. In Findings of the Association for Computational Linguistics: ACL 2026, pages 27760–27793, San Diego, California, United States. Association for Computational Linguistics.
Cite (Informal):
MHSafeEval: Role-Aware Interaction-Level Evaluation of Mental Health Safety in Large Language Models (Lee et al., Findings 2026)
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https://preview.aclanthology.org/ingest-acl/2026.findings-acl.1382.pdf
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